Is it wise to specialize right after nursing school if you know that's what you want to do

Editorial Team / Moderator · Oct 21, 2018

You don't get more broad than the ER in terms of patient presentation. I have only ever done ER in terms of bedside nursing, and I have enjoyed my career. The key is to find an ER that has a proper orientation for new grads. Good luck!

SqrB3ar, BSN, RN · Oct 21, 2018

There are nurses who have specialized right out of nursing school and never looked back. There are nurses who specialized and switched. If ER is what you want, go for it, many people jump right into it despite the whole "do med-surg first" saying. Being a CNA is great experience and gives you good insight on the units, but it doesn't necessarily give you insight on what exactly the nurse does. Once you're an RN, only you can decide what unit works for you since you'll be taking on a completely different role than a CNA. There may be other specialties that seem harder to switch from, but that depends on what the manager wants and how well you can interview in terms of how the skills you learned from your previous unit can benefit theirs. ER? No problemo!

FolksBtrippin, BSN, RN · Oct 22, 2018

Go for what you want. If you change your mind, you can switch later.

Lipoma, BSN, RN · Oct 22, 2018

I'm also a new grad and I'm starting off in the ER. When I did my last rotation as a student in the ER, we saw everything! ER nurses are true generalists.

KelRN215, BSN, RN · Oct 23, 2018

What would ER prevent you from doing if you want to change specialties down the road? I think ER is more broad than Med/Surg and I definitely went to school with people who went right to ER out of school. I went right to peds and never looked back. 11 years in, I can tell you that lack of adult med/surg experience has A) never hurt me and B) would not in any way have enhanced my career as a pediatric nurse. I have a colleague at my current job that easily transitioned from ER to complex care management.

adventure_rn, MSN, NP · Oct 23, 2018

I haven't worked in the ED, but I did volunteer in one for several years. I think that if you ever wanted to leave ED, the hardest challenge would be adjusting to the profoundly different workflow you see within inpatient units. However, if you can keep an open mind, I don't think you'd have trouble transitioning to another specialty later on if you feel like it; you just have to be ok with feeling like a new grad all over again.

NICUismylife, ADN, BSN, RN · Oct 30, 2018

I don't think of ER as a specialty. You will see EVERYTHING in an ER environment. You'll see infants, pregnant women, the elderly, trauma victims, psych patients, everything under the sun. You will gain so so much valuable experience. If you go straight into ER, you can basically go anywhere you want from there. When people are told not to specialize too soon, I think it's more like those niche specialties that they may end up stuck in, for example NICU, psych, dialysis, outpatient surgery centers, etc.

I'm NICU and I would be lost in the adult world. I barely even know normal adult vitals anymore, let alone labs or disease processes. It would take a lot of training if I wanted to change specialties. Luckily, my passion is infants, and I cannot imagine ever doing anything other than taking care of babies, so it doesn't matter to me one iota.

FurBabyMom, MSN, RN · Nov 4, 2018

I think you should apply for what you think you will love, but apply for things you wouldn't love if the things you think you will love don't seem to be working out. Be open to the possibility it may be a journey, but definitely, applying won't hurt.

I was SURE I was only ever going to be a peds nurse. I was an adult neuro med/surg tele RN for a year before going to the OR. I've been in the OR more than 6 years now. I never really considered the OR before the opportunity was staring me in the face, in fact I applied for the job "to see what might happen". I figured if I hated it, I'd work the orientation and commitment then move on to something else. I ended up loving it, and can't imagine clinically working elsewhere in the hospital.

The OR and ED are similar in that the workflows are not identical to other units, and that could be difficult to transition out of. We're also very "at this moment" focused in both of those environments. That is fine, and will likely never fully change but we need to be cognizant of our patient as a whole - while we may be dissuaded into believing we exist in a vacuum, we do not.

My advice would be don't write all other options off in favor of only one way forward. Shoot for it but if that doesn't happen right away, enjoy the path there. Spend a year or two elsewhere, learn all that you can, and then go where you want to. I learned SO MUCH from my first jobs on the floor that I never WANTED. Some of it was what I didn't want to become, and the rest of it is incredibly helpful as an OR RN. I love this specific part of this profession for so many reasons I cannot succinctly describe here. You will find where you are supposed to be. If, in fact, that is the ED, it will happen - either initially or later.